Simplifying the Search for Birth Control With a Conversational Interface
Ask Tia aims to be as smart as your doctor and as accessible as your best friend.
I t was during my first summer at sleepaway camp, between arts & crafts and swimming, when I got my first period. I was simultaneously mortified and thrilled as my counselor gave me step-by-step instructions on how to use a tampon so I wouldn’t have to sit out of swim class during that hot Texas afternoon. She was a hero in that moment and I was lucky to learn so early that women are in this whole thing together.
Technology has made it easier to reach friends, counselors, and doctors. But talking about issues like sexually transmitted infections or birth control can be fraught and complicated, which can make it difficult to get fast, accurate information. Which is why Carolyn Witte and Felicity Yost created Ask Tia.
Released in beta on June 1, Ask Tia is an iOS app designed to assist and inform women about reproductive and sexual health. Through personal, private text-based conversations, users can find the best birth control, get answers to sexual health questions, find doctors, and track periods and symptoms. Unlike most apps for women’s health, which track fertility or menstruation, Ask Tia goes a step further, enabling women to get personalized advice based on their questions and self-described history. It’s the first product from Tia, a company “for millennials by millennials” that aims to help women make informed healthcare decisions. Its most evident strength right now is as a birth control matchmaker, but the company wants it to evolve. “Our goal is to expand Tia to be your comprehensive go-to women’s health assistant for all of your health care information needs,” says Witte, Tia’s co-founder and CEO.
The app is the result of Witte’s own reproductive health struggles. After three years and countless doctors and specialists, Witte questioned why she didn’t have access to her historical health data or feel empowered to make informed decisions about her own health care. During that time, Witte was working at Google on Search and Google Assistant, researching and reimagining how people find and access information in the current state of ubiquitous mobile messaging. She knew she wanted to devote her time and expertise to innovate women’s health care, but wasn’t quite sure what to focus on.
For six months, Witte interviewed women ages 18–35 about their healthcare challenges. The common denominator became evident: birth control. With more than 50 types of contraceptive pills alone, not to mention implants, intrauterine devices (IUDs), and hormonal rings, finding the right birth control — or the one that’s not right — can be a difficult process. So, Witte decided to leave her job at Google and build a recommendation engine that would make the process suck less. “You have personalized Amazon recommendations, personalized Netflix recommendations,” says Witte. “Why can’t you have personalized birth control recommendations?”
After downloading Ask Tia, users are asked to register with their phone number, which is the only identifiable information that Tia collects to ensure that user data is secure and anonymous. Health data is stored and encrypted separately from user accounts. Once in the app, users can select from a menu of options including “set up reminders” and “ find a doctor.” If a user wants help choosing a birth control, Ask Tia’s quick sex-positive questionnaire offers insights into the birth control that’s recommended for them and why, with all the nitty gritty details a user might want to research.
Users can also ask questions. Witte says they’ve received questions ranging from “What’s a deductible?” to “Tell me about IVF.” About 90% of the time, one question leads to another. And if a query is too complex for the automated system, Ask Tia calls in a trained women’s health educator — a “Wing Woman” — to offer more informed advice or ask further questions. These educators aren’t doctors, but are trained in sexual and reproductive health, according to Witte. “While automation is important to longterm scale, our priority right now is designing systems that maintain high-quality, personalized and compassionate responses,” she says. The user is told when a Wing Woman is joining the conversation, making a seamless and transparent bot vs. human interaction experience.
Early testing and focus groups revealed that women often have the same health questions, but nowhere to comfortably ask them. The result: women feel alone in their experiences. They “would preface their stories by saying something like, ‘I’m probably the only one to ever tell you this, but…’” says Witte, who said she heard it multiple times a day. That led to the development of the Tia Talk Tuesdays feature, in which a top question from the community is posted with a conversational answer. By showing a user which questions are common, Witte hopes that secrecy and embarrassment will abate over time.
Witte and her team decided to build Ask Tia as a conversational interface in a native app, rather than using SMS or social media integration, to engender trust. They wanted to create the type of personality that would make women confident and comfortable enough to ask sensitive questions and divulge personal health details. Witte describes this personality as a “cool aunt” — a person with more life experience than your best friend, but not as close to you as your mom. “She’s the person you turn to when shit hits the fan,” says Witte. The choice seems to be working. “The number of users who send Tia heart emojis is really profound.”
Building a trusting relationship with an app isn’t easy. Tia’s crew of advisors, which includes Dr. Aparna Sridhar, a UCLA professor and OB-GYN, and Sally Rafie, a pharmacist specialist at UCSD, has prioritized personalizing the information for each user. Even a simple question about missing a birth control pill has several factors (type of pill, where in your cycle, etc.), which is why Tia’s guiding questions and personalized assessments so much more valuable than, say, a Google search. “Tia cuts out the noise,” says Witte. “She helps provide you a private, personalized answer that addresses your individual needs.” And, like any sort of intelligent assistant, Ask Tia was developed to learn each user, offering smarter recommendations based on a longer contextual history.
During the week I tried it out, I found myself wanting to check in with Tia. In fact, I opened the app almost daily, just to check in, track my cycle, or ask a question — which is exactly how Witte wants users to feel. “Sometimes,” she says, “the listening is just as important as the answer.”
